Date: 2012-03-01

When my generation of Emergency Medical Services (EMS) personnel thinks of data sharing in the field we have visions of Squad 51 using their Biophone; a combination voice and telemetry radio communications system. The paramedics could call the base hospital and not only talk to the doctor but they could also send live cardiac data by way of electrocardiogram rhythms.

Many of us still remember the days of VHF radios in our ambulances. However, many of us lacked the use of portable radios. And as for calling anyone, we would often find the one land-line telephone in the patient's residence, and we were excited when it was a push button style. Then came the 1990's and the cellular telephone. This brick allowed us to call “anyone” we wanted to from the field... as long as there was coverage and the battery didn't die.

Today our staff has many options when it comes to voice communications. We provide them high end portable radios with capabilities in VHF, digital, and even encrypted channels. They often carry a portable radio worth thousands of dollars... yet they still use these devices as glorified walkie-talkies. Many agencies have provided their staff with cellular telephones, however many have locked out most of the applications and even the ability to call freely due to cost and security concerns. Rarely are these voice devices used to their full potential.

Back in the day, we in EMS also had the future shown to us when Star Trek’s Dr. McCoy used his tricorder to asses and diagnose a patient... often the poor security guy in the red shirt. Every science fiction story had some hand-held device designed to asses and to treat patients. Well the future is now. We are coming into a generation that will know these types of devices. On any given day the average 10-year-old is carrying a device with more voice and data sharing capabilities in his or her pocket then we provide our front-line responders.

Even as I am writing this article I just looked through the App Store on my phone and found apps for stethoscopes and heart scans. There has been work done on other Smartphone applications such as an app to reproduce the techniques ophthalmologists and optometrists use to determine the prescription that a patient needs and a lens-free microscope weighing less than two ounces and designed to attach to most camera-based cell phones. The microscope will allow in-field samples, such as blood and saliva smears, to be loaded onto single-use chips that slide into the microscope; and because of the large aperture of the sensor array, no special alignment or cleaning techniques are necessary - which makes this technology ideal for field use. While paramedics currently take blood glucose tests in the field, can one imagine the support, especially in rural parts of our country, where more expansive testing would come in handy?

While there are currently thousands of medical apps in the App Store and more being developed each day, the Smartphone technology is only one device in our future medical jump kit. Telemedicine expands the care patients can receive both in the field and also in remote areas of our country. Live video feed and data sharing bring immediate consultations from tertiary care centers to remote clinics and hospitals.

Live data can also greatly assist EMS providers in their scene response and deployment. Imagine that the ambulance that is responding to the intersection for a motor vehicle incident could tap their on-board computer into the intersection camera; allowing the paramedics to actually see the incident prior to their arrival on scene. Or even earlier than that, the Emergency Medical Dispatcher could look at the camera's and determine firsthand how many resources might actually be required - after the cell-phone rescue ranger called in Armageddon.

Data sharing with our partners will allow paramedics to communicate directly with health care providers as well as other first responders such as fire and police services. Having joint access to such tools as in building 3D and building cameras will allow EMS commanders to monitor their staff in dangerous situations. Using this technology ensure that we are not only providing the best care for our patients but that we are also looking after our staff.

Limitations of Accessing New Technology

But all of these great devices, and more not yet invented, come with limitations. The biggest issue before us currently is securing the bandwidth required to operate these devices in the field. Much like our original brick cellular telephones not having coverage, our data devices will only work as good as the system they are supported by. This is where 700 Mhz Broadband for Mission Critical Public Safety Data comes in.

700 Mhz broadband is still the great unknown to many non “tekkies” out there. It is not your answer to replacing your ageing voice system. It is, for now, specifically for transmitting data. August 30, 2011 marked the transition from analog television to digital, freeing up spectrum for potential use by public safety. Many private and public agencies are vying for this valuable spectrum, and Industry Canada (our nation’s spectrum regulator) opened consultations on the 700 MHz broadband allocations on December 1, 2010. On February 28, 2011, the Tri-Services Special Purpose Committee on 700 MHz Broadband for Mission Critical Public Safety Data (on behalf of the Canadian Association of Chiefs of Police [CACP], Canadian Association of Fire Chiefs [CAFC] and Emergency Medical Services Chiefs of Canada [EMSCC] and its public safety partners) submitted its response to the Industry Canada consultation.

Public Safety in the United States of America has been working for years on a similar initiative. On February 17, 2012, US Congress agreed to allocate the “D Block” to public safety and support the development of a mission-critical, nationwide public safety broadband network. In a live webcast press conference four key Democratic Senators invoked stories about police, fire, and EMS personnel killed on 9/11 as they announced an historic deal to give America’s first responders a nationwide interoperable wireless broadband network. On February 22, 2012, President Barack Obama signed into law the payroll-tax-cut extension legislation, which reallocates the 700 MHz D Block spectrum to public safety and provides $7 billion in federal funding to help pay for the build out of the nationwide LTE network for first responders. This is good news for Canada as public safety we continue to raise awareness about securing the corresponding block of spectrum for Canadian responders.

Once Canadian efforts secure the spectrum and start to build this North American–wide capability, the issue of radio and IT convergence becomes all the more important. Public safety leaders and politicians must constantly be reminded that this spectrum is not designed for traditional responder’s radios but for broadband data. These data include video, situational awareness, in-building 3-D location and tracking, wireless sensors for hazardous materials situations, and so on. These systems all require large amounts of data and a network with sufficient capacity that is dedicated to public safety requirements. Canadian police, fire, EMS and other emergency professionals must have access to modern and reliable communications capabilities, including high speed data and video, to communicate with each other across agencies and jurisdictions during emergencies and during day-to-day operations. Public safety’s voice must be heard — we need the right tools to protect and save lives.

There are those, mostly in industry, that suggest that responders would be best supported by commercial networks. While we all currently use commercial networks for our voice applications there have been a number of issues including the lack of pre-emption for our devices. One does not need to look far to find examples of systems failing due to non-robust systems that crashed due to disasters or systems quickly overloaded by too many users on the networks. We cannot afford to make this same mistake with broadband. We no longer want to be in line in the lobby waiting for our turn to use the spectrum. We must place ourselves into the boardroom where the decisions are made on its usage.

To ensure public safety remains a top priority, EMS professionals must have access to modern, reliable, and robust communications capabilities, including high speed data and video, to communicate with each other and across agencies and jurisdictions during emergencies and also for day-to-day operations. Paramedics cannot continue as a customer forced to wait for service when bad things happen. The EMS community needs to “own” and be in control over who has access to this spectrum and when. For instance, paramedics should not have to compete for bandwidth with the teenager who is sending live video to all of his friends of the very emergency those paramedics are dealing with. Not surprisingly, there is a public expectation that when things go wrong, a responder can communicate within his or her own agency as well as with partners in the community. Dedicated bandwidth will ensure this public expectation continues to be a reality.

Action Needed to Reach Solutions

Using a system-of-systems approach, EMS agencies should be able to communicate, using voice and data, from coast to coast and North and South. Ideally a paramedic from British Columbia should be able to step off a plane in Halifax and have his equipment immediately be recognized by the system. The system would allow this paramedic to communicate seamlessly with other responders and share their data.

EMS leaders must join together and take action now. This is a once in a lifetime opportunity that ties directly to community and responder safety, innovation and the health of Canada’s digital economy. Do your part:

Inform your boards, municipalities, provincial/territorial governments and other governing bodies that spectrum allocations will have a significant impact on public safety in Canada;

Work with your tri-services colleagues and others to advocate a strong voice for public safety in advance of spectrum allocations;

Look for and act on mobilization information as it sent by EMSCC and others;

Join The Canadian Interoperability Technology Interest Group (CITIG), www.citig.ca

One other area in which EMS Leaders can help move interoperability forward in Canada is to join and support CITIG. Since 2007, CITIG has been an incredibly valuable organization to the emergency responder tri-services (police, fire, and Emergency Medical Services) as well as their national and international partners (Industry, all levels of government, and NGO’s). CITIG is recognized as the unified voice for first responders on all interoperability issues. It has demonstrated its abilities by its collective approach and a strong track record of measurable delivery and achievements in short timelines. Responder interoperability remains a key priority for all three of the associations, and the future of CITIG must be secured. Membership is free, but the return is priceless.

It is incumbent on each of our agencies to provide our staff the best and most up-to-date equipment available. EMS organizations must not only keep up with current technologies, we must also work with industry and governments to make these technologies available to everyone and they must be cost effective. While our paramedics all like new toys, this is more than giving them new bling for their gear belts. This is about providing our EMS staff the required equipment to take care of our patients as well as themselves in the field. We have come a long way from calling Rampart on our Biophone... and we are well on our way to tricorder medicine... but we need to be the generation that sees this into realization.

Pascal Rodier is Superintendent of the British Columbia Ambulance Service (BCAS). He began his career as a Paramedic with the BCAS in 1988; after receiving numerous promotions he was promoted to Superintendent in 2008; in September 2011 he was assigned to the Lower Mainland Regional Operations. Superintendent Rodier was one of the original planners of, and has been, the BCAS’ project team leader for the province-wide expansion of the Combined Events Radio Project (CERP) since 2003. He is a member of CITIG and was a part of the national working group that wrote, the recently approved, Communications Interoperability Strategy for Canada and the Communications Interoperability Action Plan for Canada. Also, he is currently the EMSCC Representative and Co-Chair on the Tri-Services Special Purpose Committee on 700 MHz Broadband for Mission Critical Public Safety Data. He may be reached by e-mail here .